The overall goal of the proposed fellowship pediatric cardiololgy (sp) training grant program is to develop pediatric fellows into well-trained investigators with the potential to assume leadership roles in the nation's congenital heart disease research agenda. Through this two-year training program they will acquire the ability to perform exceptional clinical and basic science research into the causes, pathological mechanisms, and outcomes of congenital heart disease. Few Pediatric Cardiologists are trained to conduct research and comparatively few pediatric fellowship graduates have careers successfully performing such research, and the need to intensify and expand training programs is clear. At least eight of every 1,000 infants born each year have a heart defect - almost one percent of live-born infants. In fact, congenital heart disease is a leading cause of death during the first year of life. The acute care cost of treating these infants each year, exceeds $400,000,000. This estimate does not include the chronic care costs of clinic visits, medications, and rehabilitation. The program expands the current three-year fellowship training program to four years by adding an additional research year -- either in clinical or basic science research. Furthermore, it enhances the current one by offering trainees access to a wide range of additional Duke research resources and, thus, potential mentors. Examples of such resources include the Duke Clinical Research Institute, the Center for Genome Technology, and the Center for Human Genetics. The overall direction of this program will be provided by Dr. Stephen P. Sanders, a renowned pediatric cardiologist and Program Director of this training program. The multidisciplinary clinical research training program is designed to provide young clinical scientists with the tools and skills needed to perform innovative clinical research, translating and testing basic science discoveries in the clinical arena. Improved therapeutics, realized through the efforts of clinical investigators trained in this program, is the ultimate goal. The basic science research training program is designed to give young investigators the knowledge and skills needed to perform cutting-edge scientific research and succeed in the highly competitive research environment of academic pediatrics. Moreover, one of the most significant goals of the program is to ensure that young physicians will be able to translate, for the benefit of patients, research findings into clinical practice.